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Nevada rates for HCPCS Q4203

Derma-Gide, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$871.37 / $871.37 / $1,147.65
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,052.89 / $1,052.89 / $1,158.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$288.86 / $288.86 / $1,045.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,052.89 / $1,052.89 / $1,052.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,052.89 / $1,052.89 / $1,052.89
Hometown Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$179.61 / $998.00 / $1,142.28
Hometown Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.38 / $127.38 / $191.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,052.89 / $1,052.89 / $1,052.89